Does Intracorp *always* require proof of medically supervised weight loss attempts?
My employer (Gallagher Bassett Services) is self-insured and self-administered, but they use Intracorp to determine medical necessity. I just got a letter from my insurance today advising me that my pre-determination request for BPD/DS has been forwarded to Intracorp for medical necessity review. I'd heard that Intracorp requires at least one and sometimes two 26-week-long medically supervised weight loss attempts before they'll deem WLS medically necessary. This scares me, because I don't have that-- didn't see the point, seeing as dieting all my life got me where I am today, with a BMI of 56! The info I could find here about Intracorp was a bit confusing... it appears that their requirement vary. Have others found this true? I'm hoping that this is the case, especially since my employer is self-insured and I *was* told when I initially inquired that they went by the surgeon's recommendations to determine authorization. They didn't tell me, though, that Intracorp would have any role in determining medical necessity. I suppose if I'm denied I could hire Walter Lindstrom! Any info that any of you could share about experiences with Intracorp is appreciated.
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